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Living and Dying Along Class Lines

If Atty. Gen. Ashcroft has his way, only America's well-to-do will have access to death with dignity.

May 13, 2003|Pamela Fitzsimmons | Pamela Fitzsimmons is a writer living in Vancouver, Wash.

Thanks to Atty. Gen. John Ashcroft, I recently went out and bought a copy of "Final Exit" by Derek Humphry.

Published in 1991, this 192-page book is subtitled "The Practicalities of Self-Deliverance and Assisted Suicide for the Dying." It includes chapters such as "Shopping for the Right Doctor" and "How Do You Get the Magic Pills?"

I may need this book.

A couple of years ago I moved from Southern California to Vancouver, Wash. One of the first things I did was pick a doctor under my employer's insurance plan.

I decided on a physician in Portland, Ore., just across the Columbia River, only 12 miles from my Vancouver home and in a state where voters approved the Death With Dignity Act, which allows physician-assisted suicide.

Although the law covers only Oregon residents, I was born in that state, still have relatives there and live minutes from the state line. It would be easy to shift residency if I had to.

This was a practical consideration. Twelve years ago, I had cancer followed by six months of chemotherapy. That ubiquitous phrase "quality of life" took on real meaning. I began to think seriously about what I could and couldn't live with.

Now along comes Ashcroft to decide for me.

The U.S. attorney general has decreed that Oregon's Death With Dignity Act is in conflict with federal drug laws and that federal law takes priority. The federal Controlled Substance Act classifies some drugs, such as heroin, as having no legitimate use. The federal law classifies some other drugs as having useful medical purposes; Ashcroft has decided that prescribing a drug to assist a patient's suicide is not a legitimate medical purpose.

A U.S. district judge ruled that Ashcroft exceeded his authority, and the matter is now before the 9th U.S. Circuit Court of Appeals, which heard arguments Wednesday. No matter what is decided, the issue will probably end up in the U.S. Supreme Court.

Death with dignity is headed for the same fate as abortion rights: a never-ending battle in which those in or below the middle class suffer the greatest.

The wealthy will not die a painful death if it can be medically avoided, any more than the daughters of the rich suffered from back-alley abortions before Roe vs. Wade.

What are the odds that an Ashcroft or a George W. Bush is going to die needing more painkiller that he cannot afford? Or die languishing in a grim adult-care center that reeks of human waste? Is that how Jackie Onassis or Linda McCartney died? Of course not.

For the wealthy, death can be a discreet matter of a doctor or nurse inching up the morphine drip. Forget the legal arguments. Forget religious and moral issues. Let's talk class.

What's it to politicians like Ashcroft or Bush if I am dying and don't want to prolong my life? To them, my life -- all life -- is supposedly sacred. It isn't. If life were sacred, health care would be free.

So what's in it for Ashcroft and Bush? I've pondered that question, and I keep coming back to this: Do powerful men like them instinctively sense that their world would be turned upside-down if the lower classes had more control over their own fates?

Consider the practical results of a right to end one's life. Families could be spared the costs -- financial and emotional -- of loved ones being used as virtual guinea pigs. There might be a more realistic acceptance of what doctors can and cannot do. Doctors cannot always heal; sometimes the best a patient can hope for is a good death.

Even if Ashcroft gets his way, there is still another suicide option available to ordinary folks, one that he won't touch: guns.

As Humphry points out in "Final Exit," shooting is "definitely not the exit of choice for believers in euthanasia." It's not error-proof. It's bloody and violent, and somebody has to clean up the mess. Of course, the lower classes are used to cleaning up messes.

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